Myroides bacteremia associated with wound myiasis: A case report and focused literature review

Myroides is a gram-negative rod that most commonly affects immunocompromised hosts. Traditional risk factors for infection include soil or water exposure, but one less well-described risk factor is myiasis: the infestation of living tissue by maggots. We present a 50-year-old man with end-stage liver disease and chronic lower-extremity wounds who developed Myroides bacteremia in association with nonsterile maggot infestation. A literature review of PubMed, Ovid (Embase and MEDLINE), Web of Science, and Scopus identified three other cases of Myroides infection in the setting of myiasis. Myroides has been identified as part of the gastrointestinal microbiota of two fly families whose larval stages are implicated in myiasis. We propose that transmission occurs via inoculation of wounds with larval oral secretions or feces. We examine the pathogenesis of Myroides and the uncommon association between Myroides and myiasis.